Digital healthcare

1. The Digital
Healthcare Leap
Digital health in emerging markets
August 2016
www.pwc.com/global-health
www.pwc.com/gmc
In this paper
3 The digital healthcare
dilemma in emerging
markets
6 Do traditional digital health
business models have a role
in emerging markets?
10 The leap forward

3. Foreword
David McKeering
PwC Global Healthcare Markets Leader
PwC South East Asia Consulting
Whether we like it or not, technology has become part of our
lives. It has arguably helped us as individuals become more
informed and more connected. The use of technology is
embedded in the industries of banking, automotive, insurance
and retail. Today the health sector faces a daunting new digital
challenge: unleashing the power of technology to fundamentally
reinvent how care is delivered. On top of their existing technology
needs and priorities, today’s health providers need to address the
digital requirements demanded by health policy or by consumers
and other stakeholders.
Digital Health initiatives rely heavily on having the right
information in the right place at the right time for use by the right
clinician. To really use technology effectively in health, we need
systems to interact with one another to provide the data required
to make informed decisions about the delivery of care. ‘Digital
healthcare’ is not about the technologies, it’s about new ways of
solving healthcare problems, creating unique experiences for
patients and accelerating healthcare providers’ growth. Over the
longer term, digital healthcare will help system-wide operations
and organisations to deliver more powerful healthcare.
Yet these challenging financial times discourage all but the most
prudent, high-return investments. Advanced, enterprise-wide digital
health solutions should head many emerging healthcare providers’
lists of ‘must have’ capabilities; however, traditional digital
healthcare models often come with high costs. Our experience is
that digital health can dramatically improve an organisation’s
productivity and, in turn, provide benefits in both patient outcomes
and the bottom line. This means that if the costs of digital healthcare
solutions can be made affordable, digital health could be an answer
to the emerging markets’ challenge to achieve sustainable growth
and leapfrog the developed nations to provide quality, affordable,
universal and patient-centric care.
PwC | The Digital Healthcare Leap | 1

4. Growing population
Many emerging markets in the Asia-Pacific region
are yet to reach their ‘peak’ population3
Projected population growth (2015-2050)
Japan
7%
decrease
Population in 2050
93%
Philippines 65%
increasePopulation in 2050
165%
Malaysia 50%
increasePopulation in 2050
150%Indonesia40%
increase Population in 2050
140%
India46%
increase Population in 2050
146%
China8%
increase Population in 2050
108%
Growing middle class
of the global
middle class
will be in
Asia-Pacific
by 20304
2/3rds
Ageing population
• Emerging markets will account for
80% of the world’s elderly by 20501
• Some emerging markets should
expect a significant increase in the
portion of their population aged 65+
between 2015 – 20502
10%
30%
Thailand
7%
21%
Vietnam
2050
2015
Urban-rural divide
• Over 50% of the emerging market in
Asia-Pacific live in rural areas6
Percentage of population in rural areas (2015)5
50% 50% 56% 44% 66% 34% 67% 33%
Thailand Philippines Vietnam India
Urban
Rural
Increased prevalence of non-communicable
diseases (NCDs)
• 68% of total deaths globally occur due to NCDs; emerging
markets account for 75% of these deaths7
• Almost 200 million of the world’s 370 million people
diagnosed with diabetes live in Asia8
Prevalence of diabetes
as % of population8
Characteristics of
healthcare in
emerging markets
Indonesia
3.4
2012
8.6
2030
Malaysia
3.2
2012
8.5
2030
Philippines
2.9
2012
8.1
2030
Vietnam
0.9
2012
2.6
2030
Thailand
2.3
2012
4.1
2030
Healthcare demandinemergingmarkets is growing,drivenby anumber offactors
suchasagrowingpopulationas well as anageingpopulation.Withthegrowing
middleclass andrisingincomes,peoplearespendingmoreonhealthcare.Non-
communicablediseases suchas diabetes areno longer‘richcountry’diseasesand
theirprevalenceis increasinginemergingmarkets.Inthesecountries mostofthe
healthcare infrastructureis concentratedinurbanareas,whilemorethan50%of
thepopulationlives inrural areas.
2 | The Digital Healthcare Leap | PwC

5. The digital healthcare dilemma in
emerging markets
The healthcare gap
Expenditure on healthcare is increasing exponentially in
emerging markets (see Figure 1). As incomes are rising and the
middle class is growing in emerging markets, people are
spending more on healthcare and demanding better healthcare
services. With changing lifestyles and people living longer, there
is a tectonic epidemiological shift from communicable to chronic
disease such as diabetes, cardiovascular diseases and cancer.
While developed economies also have their challenges with
affordability of care, their fundamental infrastructure is in place,
for the most part, and their population growth remains relatively
steady. Improving healthcare access and quality is becoming a
priority in emerging markets. However, these countries have
significant strain on their health systems. Digitisation of health
services, if done in a different model, can help to improve the
quality of and access to care while reducing costs.
On the demand side, the patients/consumers in emerging
markets are becoming more discerning around their own health
and customer experience has become a key motivator for
providers. Healthcare providers that fail to adapt to this
consumer shift will risk consumers turning elsewhere to have
their health needs met. For example, in Indonesia, patients are
increasingly travelling to neighbouring countries such as
Malaysia and Thailand to access better healthcare services.
On the supply side, the healthcare system in the emerging
markets is characterised by underdeveloped infrastructure and
faces an acute shortage of resources (see Figure 2). Governments
are looking to improve healthcare access and affordability. They
are implementing universal healthcare coverage and increasing
national budget allocated to healthcare to upgrade the existing
Figure 1: Healthcare expenditure is increasing exponentially in emerging markets
9%
Source: Business Monitor International (BMI)
85% 78% 74% 71% 65%
15% 22% 26% 29% 35%
2005 2010 2015 2020 2025
Emerging
Developed
Healthcare expenditure developed vs. emerging markets (%)
There is a clear burning platform and
opportunity to address the growing burden
of healthcare costs and corresponding impact
on economic productivity due to ill health
(the impact of non-communicable diseases
like cardiovascular, cancer and diabetes is
estimated at 4–6% of GDP across the APAC
region). Solutions will require robust analysis
and foresight, leadership and multi-stakeholder
public-private partnerships.
CAGR between
2015 and 2020 in
emerging markets
facilities as well as to add new facilities. However, considering
the gap and what is needed to bridge it, the traditional model for
growth would not be sustainable.
For example, Indonesia is looking to expand its national
insurance programme to all its citizens by 2019. In 2015, it
allocated 5% of its national budget to healthcare.9
However, it is
already facing a funding gap and has an acute shortage of
healthcare resources. It would need an additional ~900k hospital
beds and ~700k physicians to provide healthcare services
comparable to those available in OECD (Organisation for
Economic Cooperation and Development) nations. To ensure the
long-term sustainability of its national healthcare program,
Indonesia needs to look at innovative technology and disruptive
business models.
Sarah Butler
PwC Australia National Healthcare Leader
PwC | The Digital Healthcare Leap | 3

6. By 2035 the global shortage of
healthcare professionals will
reach 13 million from
7 million today10
Over 1/3 of countries
suffering from this shortage
are emerging markets11
Weak tertiary and continuing
medical educational system limits
quality of knowledge distributed
in emerging markets
Figure 2: Emerging markets are characterised by underdeveloped infrastructure and face an acute talent gap
Source: Business Monitor International, 2015; OECD Data, 2014
Low
Gap
Moderate
Gap
High
Gap
Australia
3.9
4.4
Physicians
Hospital beds Indonesia
1.0
0.4
India
0.8
0.8
China
3.3
1.8
S. Korea
8.8
2.3
Japan
12.3
2.5
Philippines
1.1
1.2
Vietnam
2.9
0.8Thailand
2.2
0.4
Infrastructure and Talent Gap
OECD average
4.7
3.3
Singapore
2.0
2.3
Malaysia
2.0
1.6
4 | The Digital Healthcare Leap | PwC

7. Adoption of traditional Electronic Health Records (EHR) is still
low in emerging markets (see Figure 3). These markets mostly
use paper-based solutions and outdated IT equipment.
The traditional EHR solutions have mostly been implemented in
developed markets and represent a monumental change
transformation which can be measured in decades, rather than
months or years. There is a significant up-front cost required to
purchase and install EHR as well as training costs and ongoing
maintenance costs. The USA Congressional Budget Office (CBO)
reported that, on average, EHR implementation costs for
hospitals amount to approximately US$14,500 per bed with
annual operating costs of US$2,700 per bed per year.12
For
example, USA based healthcare provider, Lifespan, announced
plans to implement Epic’s EHR in March 2013, and the health
system went live in April 2015. The implementation is estimated
to have cost US$100 million.13
Healthcare providers in emerging
markets are unlikely to be in a position to afford such
prohibitively expensive operating costs from major EHR vendors.
However, the adoption of digital healthcare solutions including
EHRs in emerging markets could change dramatically in the next
few years. With the internet and smartphone penetration growing
and the technology infrastructure moving to cloud-based services,
this presents the opportunity to develop innovative and cost-
effective solutions to deliver healthcare services. These new
digital healthcare models involve rapid prototyping, design and
implementation which presents a great opportunity for emerging
markets to leapfrog the developed markets.
Also it will be easier to implement innovative solutions in
emerging markets because of fewer sunk costs, given existing
infrastructure and equipment, lower fixed costs from building
overcapacity, weaker vested interests and less divided public
opinion than is typical in established markets.
Digital adoption in emerging markets
Figure 3: Digital adoption is still low in emerging markets
Source: Statista, HIMMS Analytics Electronic Medical Record Adoption Model, PwC Analysis
*Note: EHR Adoption includes usage of medical records, health records, and other digital solutions by hospitals and physicians to deliver healthcare service.
Over the next decade, developing countries
will need to spend billions on healthcare
infrastructure and services. Advancements
in technology must be considered with these
investments. Where urgent needs prevail
in emerging markets with limited access to
healthcare, the learnings from costly EHR
implementations in development markets must
be considered to determine a more affordable
path forward. Similarly to how wireless
solutions have allowed developing countries to
leapfrog fixed line infrastructure investments
for broadband access, emerging markets need to
consider innovative EHR solutions that will allow
them to leap towards improved healthcare that is
more affordable.
Vaughn Kauffman
PwC Global Healthcare New Entrants Leader
Low
25% 25%-70%
India
China
US
Philippines
VietnamIndonesia
Thailand
Singapore
Germany
S. Korea
Denmark
Netherlands
Japan
Canada
Australia
Malaysia
UK
70%
Population size
Medium
EHRAdoption*
Internet Penetration (2015)
High
Emerging
markets
PwC | The Digital Healthcare Leap | 5

8. Traditional digital
health model
Digital version of
patient information
Coded
Data centred
Siloed
Paper based health
solutions
All paper records
New digital
health model
Cloud based
Open source
Integrated
Social
Mobile
Do traditional digital health business
models have a role in emerging markets?
Traditional digital health models
Most developed countries have moved away from paper-based
healthcare solutions and have adopted or are in the process of
adopting ‘traditional’ digital healthcare models (see Figure 4). These
traditional models require the purchase or lease of hardware and
software as well as dedicated space to house servers/data centres.
These systems are coded, siloed, fully customised and require
highly skilled programmers and IT professionals to develop and
manage solutions. The developed markets are now moving to a new
digital health model with increasing adoption of cloud and mobile-
based technology in the healthcare system. But integration and
interoperability challenges of existing traditional models will make
this progress slower.
For example, in Singapore, the National Electronic Health Record
(NEHR) system was rolled out in 2011. It allows patient healthcare
records to be shared across the entire healthcare system. Currently,
all community hospitals, 56 community healthcare providers and
close to 40% of GP clinics have access to NEHR.14
The Singaporean
government aims to get the remaining private players on board as
well. It invested US$128 million to develop Phase 1 of the NEHR,
and is paying about US$15 million each year in maintenance costs.15
Singapore is now transitioning to a new digital health model. It is
looking to move health information to the cloud. Named as hCloud,
the project will cost US$37 million for the first ten years.16
However,
it will help to bring down the cost of running the Healthcare IT
system. Future developments will also include the use of data
analytics to support both decision making at the point of care and
national planning for the Ministry of Health (MOH).
Emerging markets will reset the delivery model
for EMRs and EHRs in the next few years. The
lack of legacy infrastructure can liberate health
systems (both public and private) from the
financially daunting capital costs which have
led to government-sponsored initiatives such as
Meaningful Use in the United States. Cloud-
based technology, mobile enablement and fees
for service models will lead to faster deployment
and increased benefits for patients. Perhaps
then the emerging markets will instead become
the leaders, with the followers quickly shedding
their ‘on premises’ technology.
Time
Improvedhealthoutcomes
John Forsythe
PwC Australia, Southeast Asia,
New Zealand Digital Healthcare Leader
Figure 4: Emerging economies will leapfrog developed markets and adopt the new digital health model
Em
erging m
arkets
6 | The Digital Healthcare Leap | PwC

9. Emerging economies are unlikely to adopt the traditional digital
health models. There is a significant gap in most of the
parameters required for successful adoption of the traditional
digital healthcare model, including affordability. Figure 5
compares emerging economies in Southeast Asia to Singapore on
the ten parameters required to leverage information and
communications technologies (ICTs) for social and economic
impact. An emerging market such as Indonesia lags behind
Singapore in terms of the political and business environment,
infrastructure, affordability, skills and stakeholder readiness
required to adopt the traditional digital health model.
Source: World Economic Forum ‘Network Readiness Index’ 2015
1. Political and regulatory
environment
2. Business and innovation
environment
3. Infrastructure
4. Affordability
5. Skills
6. Individual usage
7. Business usage
8. Government usage
9. Economic impacts
10. Social impacts
Singapore
Malaysia
Indonesia
Thailand
Philippines
Figure 5: Fundamental gaps in every aspect of Information Communication Technology
8
6
4
2
0
In emerging markets the new digital health model will play a
pivotal role in overcoming many of the challenges impeding
healthcare delivery. It will help improve healthcare access,
affordability, quality and safety. Emerging markets will leapfrog
developed markets to move to the new digital health model
(see Figure 4).
Emerging markets are increasingly digitising health information.
Affordable EHR solutions are coming to market, such as cloud-
based EHR or open-source EHR, which can help emerging markets
digitise at a fraction of the cost and in a fraction of the time.
The Philippines has implemented an open source electronic
medical record system for government health facilities
called CHITS (the Community Health Information Tracking
system). CHITS is managed by the UP Manila – National
Telehealth Centre. The program has been able to improve health
care delivery in government health centres. Nurses and midwives
who usually record health data on paper were trained to use the
system to generate timely reports for DOH national vertical
health programs. Through the program implementation, delays
in accessing health data were minimised, giving more time for
health workers to give care to patients at the health centre.17
Many private sector providers in emerging markets have also
opted for cloud-based solutions. There is strong support for
healthcare cloud systems from both public and private hospitals
in Malaysia and the Philippines. Mary Johnston Hospital in
Manila, in the Philippines, implemented a cloud-based EHR
solution called HarmoniMD. This solution is built from the
ground up using the latest cloud technologies and helps leapfrog
over legacy server-based applications.18
Similarly, the Philippines-
based company Lifedata offers a web-based electronic medical
records system. It has also signed an agreement with the
Philippine Medical Association (PMA) for the ‘standardisation
and computerisation of clinical practices in the Philippines’.19
Digitising the health information lays the foundation of the
digital health model in emerging markets. For best outcomes,
other healthcare innovations such as telemedicine, mHealth
applications and e-prescriptions will be built around the digitised
health information.
New digital health models
PwC | The Digital Healthcare Leap | 7

10. The new digital health model is focused on four key elements –
disruption, engagement, integration and trust (see Figure 6).
Disruption – Transforming businesses through innovative
models that don’t exist in the market today.
Engagement – Enabling digital interactions between clients and
customers in a more engaging and patient-centred way.
Integration – Providing seamless access to health information
across systems and devices.
Trust – Ensuring secure information in a digital age to inspire
trust in the providers by the customers.
Making the transition to the new digital health model
Figure 6: New digital health model is focused on four key elements – disruption, engagement, integration and trust
From digitisation to disruption
New entrants are disrupting the traditional health model by offering
digital healthcare services in new and unique ways. They are
exploiting the cost-quality curve to deliver healthcare services in an
alternative setting. The new care delivery models introduced by
these new stakeholders will partially fill the healthcare gap.
The new entrants are increasingly collaborating with healthcare
providers and combining the use of EHRs and mHealth
applications. There will be an increasing influx of wearable
solutions in emerging markets that will support consumer and
healthcare desire for monitoring and tracking to be integrated into
daily life.
With fewer sunk costs and regulatory hurdles, emerging markets
will be able to transition quickly to these disruptive solutions.
A small start-up founded in 2009 in Myanmar offers web-based
and mobile application solutions related to healthcare. Its main
solution is offered in conjunction with the leading telecom
provider. The mobile application (app) helps users schedule
telemedicine consultation or appointments with doctors. Users
can also order medicine and seek health-related information
through the app. The app had a user base of around 7,000 in 2015
and the telecom partner has agreed to pre-load the app in 600,000
mobile phones in 2016, and 1 million phones the year after.
The start-up is further seeking partnerships with hospitals to
give the app to their patients. It has also developed a health
information system aimed at helping healthcare providers to
track patient data. It is also currently creating a human
resource information system to help healthcare providers keep
track of doctor entry and retirement.20
Integrated
Digitisation Disruption
Trust
Independent
Security
DigitisationPaper-based
Physician-centric Patient-centric
(Engagement)
New digital health model
Paper-based/Traditional
digital health model
8 | The Digital Healthcare Leap | PwC

11. From physician-centric to patient-centric
(Engagement)
Consumers are demanding better quality and customer service
through social, mobile analytics and cloud technologies. With
democratisation of data and increased usage of social media and
mobile, patients will play a more active role in clinical decision
making. The new digital model will focus on customer experience
and understanding patients in their everyday lives. The solution
will use customer relationship management technology to deliver
patient-centric care.
The digital solution will also act as a hub by sharing information
across a broad community to provide support, coaching,
recommendations and other forms of assistance. It will enable
patient involvement and the provision of ubiquitous and instant
feedback in order to realise new behaviours and/or sustain
desired performance.21
From independent to integrated
Consumers increasingly expect seamless management of their
information across their healthcare providers. Currently,
traditional healthcare models rely on disparate systems, multiple
sources of truth and silos of solutions that don’t support the
provider. The new digital healthcare model will transition towards
an inherent capability to ensure seamless information exchange
across system(s) of record.
Leading products must integrate data collected from disparate
devices and apps into external health ecosystems. It should be
integrated into existing activities and workflows of providers and
patients to provide the support needed for new behaviours.
As health data becomes more integrated and analytics and
Big Data becomes more prevalent, healthcare providers will
increasingly gain insight into real-time customer needs and pain
points. Analytics will help in early diagnosis, better treatment and
improved clinical decision making.
From security to trust
Cybersecurity is a growing concern in healthcare, especially given
recent disruptive ransomware incidents, and the increasing cost of
breaches. Data breaches happen for both malicious and benign
reasons, enabled by greater digital adoption. Health records are an
attractive target for criminals due to the breadth and depth of their
data, and healthcare organisations’ relatively low degree of focus
on security issues.
Ensuring secure information in a digital age to inspire trust in
consumers by their providers is critical. Security in the traditional
sense rested on a patient’s level of comfort about the protection of
the privacy of health related information and threats of
cybersecurity breaches. In the new digital health model where
measures have been established to ensure the security of this type
of information, the patient’s focus has shifted to how to establish a
trust based relationship with their healthcare provider who may or
may not be physically present.
Healthcare providers and governments are rethinking strategies
for avoiding these attacks. Employee education is a key tactic for
avoiding attacks. The players are also looking at innovative
solutions such as cloud-based initiatives, Big Data analytics and
advanced authentication to improve security and build trust.22
PwC | The Digital Healthcare Leap | 9

12. The leap forward for the emerging markets
There are substantial potential benefits of digital healthcare
solutions in addressing business challenges caused by the current
systems and processes associated with paper medical records.
The benefits are not unlike those that could be achieved in a
developed market; however, with a much lower cost base, and
much broader diversity of solutions that cross the continuum of
care, they could be significantly enhanced (see Figure 7).
Figure 7: Summary of benefits of digitising healthcare for patients, providers and payers
* EMR – Electronic Medical Records; EHR – Electronic Health Records
It is well documented that 80% of large organisational change
initiatives fail to achieve their intended objectives, particularly
in technology-related programs. Regardless of the quality of
technology developed prior to rollout, implementations often
encounter change resistance and can fail – primarily due to an
inability to manage the people, process and organisational
issues effectively.
Digital health initiatives offer the opportunity to have a
fundamental impact on the business model of the implementing
organisation. With the introduction of new ways of solving
business problems, creating unique experiences for the
customer and engaging people through digital mechanisms,
many tasks may also become automated or be eliminated, and
result in new workflows to complement digital solutions. As a
result, any company looking at digital healthcare needs to
provide substantial support to the business in order to manage
people through this change process. Attempting to implement a
digital change in a healthcare environment requires the active
involvement of clinical leaders and sponsors who are committed
to the change process and can help lead the organisation
through the change. These individuals or groups are sponsors
and champions who play a key role in driving the change.
Healthcare providers and administrators need to set strategies
that harness technology for mutual interests and mutual gain as
they build care delivery models with patients – not patient
encounters – at their centre. The companies that will emerge as
winners in this new marketplace will be those that can
articulate how technology can add value, align incentives,
strategically share and analyse data, and redeploy, extend and
expand their workforce to embrace digital enablers. The
following elements are key:
• Understanding which digital health technologies
healthcare providers and consumers value should shape
digital strategies
• Generating meaningful, actionable insights
through analytics will focus investments and yield better,
faster results
• Understanding what motivates both caregivers
and consumers to adopt and continue to use digital
technology will be critical for sustainability
• Rethinking the workforce and informing workflows
will fuel the Digital Health return on investment.
Benefits of moving to the new digital
health model
Key considerations in moving to the new digital health model
The benefits of digital healthcare can be felt
beyond patients. By assisting the prevention of
illness and supporting the provision of care
through alternative locations such as clinics,
fewer new doctors and nurses will need to be
trained and fewer additional beds and hospitals
created, which can help to reduce the overall
financial healthcare burden on governments in
emerging markets, enabling them to fund other
key areas of the economy. A whole nation
benefits from digital healthcare.
Patients Providers Payers
EMR Easier to read and understand Easy storage and retrieval; improved efficiency
and productivity
EHR Better diagnosis and treatment Coordination and informed decision-making Faster reimbursements
Personal Health
Records
Personal wellness management Consistency of information Links to healthcare
plans and lower claims
Remote Diagnostics Reduces duplicated tests and referrals Easy access Lower cost
Remote Monitoring Patient-centric integrated care Reduce emergency and re-admissions Lower cost
Telecare Access to specialist care Improves productivity and reduces burden of
healthcare resources
Lower cost
mHealth
applications
Greater patient engagement and
saves time
Proactive and targeted care
Big Data/Analytics Accurate diagnosis, better treatment Improves diagnostics and accuracy of treatment Lower cost
David Wijeratne
PwC Growth Markets Centre Leader
10 | The Digital Healthcare Leap | PwC

13. Conclusion
After decades of slow progress, it’s time for healthcare to take the
leap into the new digitally enabled healthcare era. The magnitude
of the challenge facing the health sector is considerable. Its
implications are far reaching for all aspects of society and the
economy. It is clear that the challenge of affordable and
sustainable healthcare is common across both emerging and
developed economies. Finding a sustainable solution to enable
better healthcare delivery is no longer the responsibility of the
public sector. There is a collective responsibility across both the
public sector and private sector to redefine traditional healthcare
business models to find new pathways to sustainability.
Innovative companies are empowering healthcare customers
with new solutions and forcing the entire industry to rethink the
way it does business. With the patient/customer becoming more
discerning around their own health, customer experience has
become a key motivator for providers. Consumers are no longer
passive patients, but have become more engaged and more
discerning, wielding new tools and better information to compare
providers. The near future will be marked by how well the
industry responds to this consumer shift. Hospitals and
healthcare providers that fail to adapt will risk declining
revenues as consumers turn elsewhere to have their health needs
met. The message is clear for healthcare delivery: digital is here
and if as a provider you are not prepared, you may be left behind.
Healthcare companies should look to how they will integrate and
connect their existing systems with new digital technologies and
merge the data locked inside them to generate meaningful,
actionable insights for caregivers. In the new digital health era,
digitally enabled care is no longer going to be a nice-to-have, but
rather a fundamental business imperative. Industry leaders across
providers, insurers, medical technology and the pharmaceuticals
all see major shifts in how care is being delivered. Digital
technology has the potential to bridge time, distance, the
affordability of healthcare and the expectation gap between
consumers and clinicians.
PwC | The Digital Healthcare Leap | 11

14. About the authors
David McKeering
PwC Global Healthcare Markets Leader
PwC South East Asia Consulting
T: +65 9382 5658
E: david.mckeering@sg.pwc.com
David is the South East Asia Consulting
Public Sector and Healthcare Leader and
Global Healthcare Markets Leader. Prior to
moving to Singapore, David was the
National Healthcare Leader for PwC
Australia as well as the Consulting Site
Leader for Queensland.
He has a recognised track record in both
private and public sectors, and across the
value chain of public sector and healthcare
services. David has recently led engagements
around eHealth Programs, National Health
Reform Blueprinting, Divisional Culture and
Change Projects, Clinical Services Redesign
Projects, Workforce Planning and major
technology implementations.
Christopher Norton
Director
T: +65 9784 6255
E: christopher.norton@au.pwc.com
Chris is a Director in the Australia, Southeast
Asia and New Zealand Healthcare Consulting
team. As senior member of PwC’s Southeast
Asia Consulting practice Chris leads the
healthcare consulting team in the region
working with private and public sector clients
to solve their most complex challenges.
Chris has extensive experience in Health IT,
productivity and efficiency, health service
planning, project management and change
management. Chris has over 16 years’
experience in the healthcare sector and is a
qualified registered Nurse. Prior to working
with PwC Chris worked in frontline clinical
delivery and hospital executive roles.
Aastha Gulati
PwC Growth Markets Centre
Healthcare Lead
T: +65 9861 7515
E: aastha.gulati@sg.pwc.com
Aastha leads the Healthcare sector within
PwC’s Growth Markets Centre. She
specialises in supporting organisations to
enter and expand into the emerging markets.
She has international experience in
leading and delivering strategy and
operations projects including go to market
strategies, operating model assessment
and design, business model transformation
and program management.
Acknowledgements
Rachel Caoili
PwC Growth Markets Centre Asia Pacific Lead
Spotlight authors
David Wijeratne
PwC Growth Markets Centre Leader
Sarah Butler
PwC Australia National
Healthcare Leader
John Forsythe
PwC Australia, Southeast Asia,
New Zealand Digital Healthcare
Leader
Vaughn Kauffman
PwC Global Healthcare New
Entrants Leader
12 | The Digital Healthcare Leap | PwC

15. References
1. World Economic Forum, ‘Why ageing is an issue for emerging markets’, 12 Feb 2014
2. Business Monitor International (BMI) Database
3. United Nations, 2015 World Population Prospects (High fertility variant, 2015 – 2100)
4. PwC, Changing demographics demand healthcare reforms, 2015
5. The United Nations Development Program's Human Development Report 2013, ‘The Rise of the South: Human Progress in a
Diverse World’
6. United Nations Department of Economic and Social Affairs, ‘Population Facts – Our urbanising world’, Aug 2014
7. World Health Organisation, ‘Global status of NCDs’, 2014
8. MDDI online literature review, 2014
9. Indonesia Ministry of Finance, 2016
10. WHO, ‘Global health workforce shortage to reach 12.9 million in coming decades’, 11 Nov 2013
11. Oxford Journal, ‘Health professionals' migration in emerging market economies: patterns, causes and possible solutions’, 2013
12. Congress of the Unites States – Congressional Budget Office, ‘Evidence on the Costs and Benefits of Health Information
Technology’, May 2008
13. Becker’s health IT and CIO Review, ‘8 Epic EHR implementations with the biggest price tags in 2015’, July 2015
14. Singapore Ministry of Health Website, ‘Future phase of NEHR’
15. Singapore Worker’s Party, ‘Easing the cost of healthcare for Singaporeans’, 2013. Cost data converted from SGD to USD based on
exchange rate of 1SGD = 0.75USD
16. Integrated Health Information Systems (IHIS), ‘IT boost to keep health care humming’, October 2014. Cost data converted from
SGD to USD based on exchange rate of 1SGD = 0.75USD
17. CHITS Philippines Website (https://chits.ph/)
18. Healthcare IT News, ‘Manila hospital implements cloud-based EHR’, 18 Apr 2012
19. LifeData System Inc. Company Website (http://lifedata.ph/?page_id=16)
20. KoeKoe Tech Compnay Website (http://www.koekoetech.com/)
21. PwC ‘Emerging mHealth: Paths for growth’, 2012
22. PwC ‘Cybersecurity in Health Services’, 2016
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